Injury and physical rehabilitation

4 Results for Health Topics

The combined search strategies captured a large number of peer-reviewed articles broadly related to injury and rehabilitation (n=4798). Following full review, a combined total of 47 articles met the inclusion criteria, and were related to injury and rehabilitation-related public health interventions in humanitarian crises.
A small number of papers (n=18) evaluated health outcomes and quoted some form of significance test (category A).
29 articles described health outcomes following surgical, medical, and rehabilitative interventions, but did not draw a statistical association between the intervention and the stated outcome (category B).
Each paper was quality-assessed using an adaptation based on the STROBE criteria for observational studies. Only 4% (n=2) papers were of high quality. No papers met the full STROBE criteria as sample size calculations were often absent.
Both the quantity and quality of papers increased over the course of the last 23 years. 57% (n=27) of the papers in this study were published between 2000 and 2013. 81% (n=38) of the higher quality studies were published between 2000 and 2013 (Figure 21).

The majority of studies were cross-sectional in design (n=30; 64%), followed by uncontrolled longitudinal studies (n=11; 23%). A single economic study investigated the cost-effectiveness of short-term orthopaedic missions in relief and elective contexts. Five studies were non-random trials.
The majority of studies were based on injuries seen in Asia (n=16; 34%). Ten of the Asian studies (63%) were specifically related to the 2008 Wenchuan Earthquake, Central China. The second most studied region was Eastern Europe, with 14 studies (30%). All of these studies related to conflict in the Former Yugoslavia in the 1990s. See Figure 22.

62% (n=29) of the studies were conducted in conflict settings, or with patients who had suffered conflict-related injuries.
The majority of papers reviewed or collected data from the acute phase of a crisis (n=39; 83%). A small number of papers looked at health outcomes in the early recovery and stabilisation phases (n=4 and n=4 respectively). No papers were identified that examined the relationship between preparedness and health outcomes (See Figure 23).

98% of the papers described interventions for the general population (n=46).
The majority of the papers were set in a mixed urban-rural environment (n=34; 72%). Four papers focused specifically on urban areas, while a further 9 papers focused on rural settings.
The majority of the papers examined a range of orthopoedic injuries (n=15; 32%), of which the repair of fractures featured prominently (Figure 24).

Twenty-two of the fourty seven studies described a range of surgical interventions (47%). Six papers looked at surgical external and internal fixation techniques in particular (13%). This type of operation was the focal point of published research more frequently than any other complex surgical technique. Nine papers described different forms of renal therapy, and / or fasciotomy (19%). A further four papers looked at health outcomes following limb amputation specifically (9%), while four papers evaluated different forms of rehabilitation (9%) (Figure 25).